Zepbound vs. Farxiga

See how Zepbound and Farxiga compare on approved uses, dosing, side effects, and cost.

Key Takeaways

  • Zepbound is a weekly injection approved for weight loss and sleep apnea, while Farxiga is a daily pill approved for diabetes, heart failure, and kidney disease.

  • Farxiga can cause modest weight loss as an off-label side effect, but it is far less effective for shedding pounds than Zepbound.

  • Zepbound typically costs more per month out of pocket than Farxiga, though insurance coverage depends heavily on the specific indication being treated.

Zepbound vs. Farxiga Drug Summary

Zepbound

Zepbound (tirzepatide) is a dual GLP-1/GIP receptor agonist approved for chronic weight management in adults with obesity, or overweight plus a weight-related condition, and for moderate-to-severe obstructive sleep apnea in adults with obesity. It is injected under the skin once a week. The dose is increased gradually over about five months to help limit side effects.

Farxiga

Farxiga (dapagliflozin) is an SGLT2 inhibitor that lowers blood sugar by causing the kidneys to release extra glucose into the urine. It is approved for type 2 diabetes, heart failure, and chronic kidney disease, and is taken as a tablet once a day. It is not FDA-approved for weight loss, although modest weight loss can occur as a side effect.

Zepbound vs. Farxiga Side Effects

Zepbound

Most common
Nausea (up to 29%)
Diarrhea (up to 23%)
Constipation (up to 17%)
Vomiting (up to 13%)

Farxiga

Most common
Female genital mycotic infections (6.9%)
Nasopharyngitis (6.3%)
Urinary tract infections (4.3%)
Back pain (4.2%)

Zepbound vs. Farxiga Dosage

Zepbound

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 2.5 mg once weekly Weeks 1-4
Maximum dose 15 mg once weekly Week 21 onward
Dose changes 5 increases Every 4 weeks

Farxiga

Dosage
Dosage Table
STAGE DOSE WHEN
Starting dose 5 mg once daily At the start
Maximum dose 10 mg once daily If needed
Dose changes 1 increase As tolerated

Zepbound vs. Farxiga Indications

Zepbound

Zepbound is FDA-approved for two separate uses: chronic weight management and moderate-to-severe obstructive sleep apnea, both in adults with obesity. It must be used alongside a reduced-calorie diet and increased physical activity. It is not approved to treat type 2 diabetes.

  • Chronic weight management in adults with obesity or overweight plus a related condition

  • Moderate-to-severe obstructive sleep apnea in adults with obesity

  • Used together with a reduced-calorie diet and increased physical activity

  • Not approved for type 2 diabetes, which is treated under the brand Mounjaro

Farxiga

Farxiga is FDA-approved for four related uses: type 2 diabetes, heart failure, and chronic kidney disease, in adults and in some cases children age 10 and older. It is not approved for weight loss, though this is a common off-label use. It is also not approved for type 1 diabetes.

  • Blood sugar control in type 2 diabetes, including children age 10 and older

  • Reducing heart failure hospitalization risk in adults with cardiovascular risk factors

  • Treating heart failure to reduce cardiovascular death and hospitalization

  • Slowing kidney function decline in chronic kidney disease

Zepbound vs. Farxiga Pros and Cons

Zepbound

Zepbound produces some of the largest average weight-loss results seen in clinical trials, and it is the only medication also approved for obstructive sleep apnea. It requires a weekly self-injection and carries a higher monthly list price than oral options like Farxiga.

Pros

  • Larger average weight loss than SGLT2 inhibitors in clinical trials

  • Only medication FDA-approved for both weight loss and obstructive sleep apnea

  • Only needs to be injected once a week

  • Dose is increased slowly over months to help limit side effects

Cons

  • Requires self-injection rather than a pill

  • Common gastrointestinal side effects like nausea and diarrhea

  • Roughly $1,050 to $1,100 per month without insurance, before savings programs

  • Not approved for diabetes, heart failure, or kidney disease

Farxiga

Farxiga has a long track record and covers four separate conditions, including diabetes, heart failure, and kidney disease. It is taken as a daily pill rather than an injection, but any weight loss it causes is a side effect rather than its intended purpose.

Pros

  • Taken as a once-daily pill, no injections needed

  • Roughly $400 to $785 per month without insurance, before savings programs

  • Also treats heart failure and chronic kidney disease

  • Long-standing FDA approval since 2014 with extensive safety data

Cons

  • Weight loss is modest and considered an off-label side effect

  • Risk of genital yeast infections and urinary tract infections

  • Rare risk of serious genital infections like Fournier's gangrene

  • Not intended or approved as a weight-loss treatment

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